Depression takes toll on some Greater New Haven seniors

Published
7:19 pm EST, Sunday, January 5, 2014

Gina D’Agostino holds a photo of her mother, Jeannette Piscitelli, who died in May. Piscitelli suffered from depression at the end of her life. She is shown at the Guilford Apple Rehab, where Piscitelli lived at the end of her life.
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Gina D’Agostino holds a photo of her mother, Jeannette Piscitelli, who died in May. Piscitelli suffered from depression at the end of her life. She is shown at the Guilford Apple Rehab, where Piscitelli ... more

Photo: (Peter Casolino - New Haven Register)

Photo: (Peter Casolino - New Haven Register)

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Gina D’Agostino holds a photo of her mother, Jeannette Piscitelli, who died in May. Piscitelli suffered from depression at the end of her life. She is shown at the Guilford Apple Rehab, where Piscitelli lived at the end of her life.
pcasolino@NewHavenRegister less

Gina D’Agostino holds a photo of her mother, Jeannette Piscitelli, who died in May. Piscitelli suffered from depression at the end of her life. She is shown at the Guilford Apple Rehab, where Piscitelli ... more

Photo: (Peter Casolino - New Haven Register)

Depression takes toll on some Greater New Haven seniors

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GUILFORD >> Gina D’Agostino remembers her mother as full of life, energetic and a devout Roman Catholic. But when Jeanette Piscitelli slipped into depression during her elder years, D’Agostino said her mother became a “different person.”

D’Agostino said her mother, a Branford resident who spent her final days in Guilford, struggled with depression throughout her life, but in her elderly years it grew worse. Piscitelli resided at The Hearth at Gardenside in Branford and spent the remainder of her life at Apple Rehab in Guilford. She died in May.

“When people get older, it’s just more difficult to treat,” D’Agostino said of depression.

Piscitelli was put on various medications to help ease her depression but had to stop taking certain ones due to kidney problems, and other anti-depressants began causing negative side effects, D’Agostino said.

“It makes the brain work overtime. She couldn’t sleep, and she’d have manic episodes. Sometimes, she’d say things like, ‘why is God tormenting my brain?,” said D’Agostino, a Hamden resident who works at Yale-New Haven Hospital.

As her mother’s depression deepened, D’Agostino was the caregiver, spending time traveling between her own house and her mother’s home until she made the decision to put her mother in an assisted-living facility.

“At that point, we made the decision she needed to be somewhere where there was people around at all times,” D’Agostino said.

D’Agostino says the death of her father was a contributing factor in the depression her mother suffered late in life.

A recent Institute of Medicine report says the nation is not prepared for the expected increase in seniors with mental health issues.

“The burden of mental illness and substance abuse disorders in older adults in the United States borders on a crisis,” wrote Dr. Dan Blazer of Duke University, who chaired the Institute of Medicine panel that investigated the issue. “Yet this crisis is largely hidden from the public and many of those who develop policy and programs to care for older people.”

Sue DeJuan, co-leader of a National Alliance for Mental Illness family group in Stamford, said she can relate to D’Agostino’s struggles. The caregiver believes the problems of her 95-year-old mother, Jen DeJuan, began after the passing of Sue’s father. They had been married 75 years.

“While taking care of my dad, she experienced a lot of fatigue and overload as his caretaker,” Dejuan said.

Dejuan said her mother has no history of depression or mental illness but given her mom’s age, she does not hold out hope for progress.

“She’s 95 years old. I think it’s clear we’re punching in the wind here,” she said, noting her mother can no longer read or write.

According to NAMI, one in four senior citizens suffers from some form of mental health issue — the most common being dementia, depression and anxiety — and one in 10 people over 65 is diagnosed with depression.

Those who have a history with depression can see the symptoms return later in life, according to Jennifer Glick, director of older adult services with the State Department of Mental Health. “It depends on their life circumstances. We can’t say that’s the main reason, but the risks are higher,” Glick said.

Like Glick, Dr. Beverly Kidder of the Department of Aging of South Central Connecticut said symptoms of depression can be masked by other problems, such as stomach pains, migraines or low energy.

“What one may recognize in a younger person as depression may not (be seen) the same way in someone older,” Kidder said.

According to NAMI, it often goes untreated because many people think that depression is a normal part of aging and a natural reaction to chronic illness, loss and social transition. This can lead to the signs of depression being missed by health care professionals.

“Most people usually end up going to their primary care physician, and many of these doctors don’t have enough geriatric expertise to detect anything is wrong,” Glick said.

Self-isolation also plays a part in depression rates among senior citizens, whether it’s after a spouse dies or just in retirement.

“We hear, ‘My spouse of 60 years died, I’m not ready to go out and find someone new, or ‘My social interaction was in the workplace.’ When people retire they lose that,” she said.

It’s hard to say if people purposely choose to isolate themselves, she said, but living alone is a risk factor in senior depression. She noted that “blue collar” seniors are more likely to suffer from depression than “white collar.”

Professionals agree depression in the elderly is hard to treat and say many get no treatment, resulting in drastic consequences.

Kidder said seniors who suffer from depression are six times more likely to commit suicide.

“If the depression is left untreated, the rate of suicide is much higher, especially in an older, white male over the age of 80,” Kidder said.

Terry Buckley, senior coordinator of the Guilford Senior Citizens Center, said her establishment works to prevent seniors from falling into depression with various services and activities, noting that even giving up a car can push someone into isolation.

“That’s their form of independence; they feel they can’t get out,” she said.

And as the population rapidly ages over the next two decades, millions of Baby Boomers may have a hard time finding care and services for mental health problems such as depression because the nation is woefully lacking in doctors, nurses and other health workers trained for their special needs, the Institute of Medicine report said. Instead, the country is focused mostly on preparing for the physical health needs of what has been called the “silver tsunami.”

Already, at least 5.6 million to 8 million Americans age 65 and older have a mental health condition or substance abuse disorder, the report found — calling that a conservative estimate that does not include a number of disorders. Depressive disorders and psychiatric symptoms related to dementia are the most common.

“This is a wake-up call for many reasons,” said Dr. Ken Duckworth of the National Alliance on Mental Illness. The coming need for geriatric mental health care “is quite profound for us as a nation, and something we need to attend to urgently,” he said.

Stephen Cuddy, 52 of Cheshire, agrees and said depression must be treated at the onset of symptoms. He said if left untreated, his depression may have “spiraled out of control” in his elder years.

Cuddy said during his mid-20s he experienced depression and it was left untreated until he reached 40 and was diagnosed with diabetes.

Instead of taking prescribed medication, Cuddy said he approached his depression more “holistically,” crediting exercise, volunteer work and forgiveness with helping his depression subside.

“I think in my case, I would have had a bad quality of life if I didn’t do those things as I aged. Everything tends to get worse as you get older, everything becomes a challenge. It could’ve gotten worse if I didn’t step up and do something about it,” Cuddy said.

Meanwhile, Glick said the best thing people can do is check on those seniors who are vulnerable.

“Even if someone is living by themselves, if they have someone who is checking in on them every day or calling them often, they should be fine,” he said.

Those left alone in nursing may be perceived as abandoned, but Kidder doesn’t believe this to be the case.

“I think people can’t bring themselves to visit their family there. They don’t want to see them in that position,” Kidder said.

D’Agostino said her mother called every day and when Piscitelli moved to Guilford, her daughter visited three times a week.

“We always made sure there was someone there checking in on her,” D’Agostino said.

D’Agostino suggested for those caring for a loved one suffering from depression that they find support.

“If they can find themselves one person they can just turn to for help, that’s the best,” she said, adding that in retrospect, she “thought I could only care for my mom best” but now understands “you want to work with your parents’ nurses.”

“My heart goes out to any family member dealing with this. I wish you the best,” D’Agostino said.

Call Ebony Walmsley at 203-789-5734. Have questions, feedback or ideas about our news coverage? Connect directly with the editors of the New Haven Register at AskTheRegister.com.